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Résumé: Les auteurs rapportent un cas d’ethmoïdite aspergillaire compliquée d’un abcès orbitaire, diagnostiquée chez une enfant âgée de six ans, apparemment immunocompétente. C’est une infection rare, de diagnostic difficile, ce qui retarde la prise en charge et retentit sur le pronostic. L’immunodépression et les voyages outremer constituent des facteurs de risque importants d’infections à agents normalement peu pathogènes et/ou inhabituels, notamment fongiques. La chirurgie avec l’examen mycologique et anatomopathologique du prélèvement évoquera une mycose qui sera confirmée par la culture et contribuera à la prise en charge adaptée. [Copyright &y& Elsevier]

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Abstract: The aim of this review is to describe the different forms of fungal rhinosinusitis. The interaction between fungi and the nasosinusital cavities results in numerous conditions that have different clinical presentations according to the fungus and to the immune status of the patient. The fungi will be either in the mucus or on the mucosa in its noninvasive form; invasive forms infiltrate bone, blood vessels and mucosa. The diagnostic and therapeutic characteristics of these conditions are described in this review. The newly described forms of fungal sinusitis with eosinophils are also described. [Copyright &y& Elsevier]

Fungal rhinosinusitis, including invasive and non-invasive forms (e.g., fungal balls, IgE dependant allergic rhinitis), is a well-known disease. More recently, a new entity has been described, namely, allergic fungal rhinosinitis (AFR). Since the earliest case reports of this condition, in which the diagnostic criteria were similar to those of bronchopulmonary aspergillosis, a number of reports dealing with related conditions, e.g., chronic rhinosinusitis and nasal polyposis, have also been published. In publications on AFR, the role of the fungi found in the eosinophil-rich viscous mucus remains undetermined. The present article reviews recently published evidence concerning these diseases, in particular, the diagnostic elements and the pathophysiology proposed by the authors. The criteria acceptable for a diagnosis of AFR are specified, and recent reports on the effect of antifungal treatment are analyzed. Even though these publications have increased the confusion concerning this condition, the diagnosis of AFR remains probable in certain patients, namely, when the patient’s immuno-allergic data are the same as those present in allergic conditions in general. [Copyright &y& Elsevier]